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FINALS - OBS, GYNAE, BREAST > bleeding in pregnancy > Flashcards

bleeding in pregnancy Flashcards

1
Q

symptoms threatened miscarriage

A

painless bleeding 6-9 weeks

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2
Q

symptoms incomplete miscarriage

A

heavy bleeding and cramping, lower abdo pain

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3
Q

symptoms missed miscarriage

A

little vaginal bleeding and pregnancy symptoms subside

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4
Q

symptoms ectopic

A

6-8 weels amenorrhea –> light bleeding // severe unilateral abdo pain // shoulder tip pain // cervical excitation

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5
Q

symptoms molar pregnancy

A

bleeding in fist trimester, extreme pregnancy symptoms, large for dates uterus, v high hCG

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6
Q

what is an antepartum haemorrhage

A

bleeding from 24 weeks

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7
Q

most common causes APH

A

placental abruption and placenta praevia

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8
Q

what is placental abruption

A

normally sited placenta detaches from uterine wall –> maternal haemorrhage

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9
Q

assoc placental abruption

A

pre-eclampsia // cocaine // multiparity // trauma // maternal age

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10
Q

features placental abruption

A

shock out of keeping with loss // multuparity // trauma // age

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11
Q

features uterine rupture

A

shock // continuous pain // tender, tense uterus !! // abnormal foetal heart // coagulation problems // pre-eclampsia, DIC, anuria

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12
Q

mx placental abruption if fetus alive and <36 weeks

A

distress = C section // no distress = admit and observe, steroids

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13
Q

mx placental abruption if fetus alive and >36 weeks

A

distress = c section // no distress = vaginal

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14
Q

mx placental abruption if fetus dead

A

vaginal delivery

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15
Q

maternal complications placental abruption

A

shock, DIC, renal failure, PPH

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16
Q

maternal complications placental abruption

A

shock, DIC, renal failure, PPH

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17
Q

fetal complications placental abruption

A

IUGR, hypoxia, death

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18
Q

what is placenta praevia

A

placenta lying wholly or partly in lower uterine segment (covering or within 20mm os)

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19
Q

when is placenta praevia diagnosed

A

20 week scan

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20
Q

RF Placenta praevia

A

previous c section or scars!! multi-parity, twins, TOP, >40

21
Q

symptoms Placenta praevia

A

shock (expected) // NO pain // uterus non tender // fetal heart usually normal

22
Q

invx Placenta praevia

A

do NOT perform digital exam until USS // transvaginal USS

23
Q

grading Placenta praevia

A

I = placenta reaches lower segment but not internal os // II = reaches os but does not covert it // III = covers internal os (not when dilated) // IV = completely covers

24
Q

further invx if Placenta praevia diagnosed

A

rescan at 32 weeks –> rescan every 2 weeks –> final scan at 36-37 weeks

25
Q

delivery placenta praevia

A

grades III/IV = c section between 37-38 weeks

26
Q

mx if pregnant women with known Placenta praevia goes into spontaneous labour

A

emergency C section (with or without bleeding)

27
Q

what is vasa praevia

A

unprotected foetal vessels over internal os

28
Q

diagnosis vasa praevia

A

USS

29
Q

symptoms vasa praevia

A

sudden, painless, dark bleeding after rupture of membrane

30
Q

mx vasa praevia

A

<34 weeks steroids // 34-36 deliver // emergency C section

31
Q

RF uterine rupture

A

prolonged labour!!! // IOL, previous rupture, previous C section, raised BMI

32
Q

symptoms uterine rupture

A

severe abdo pain // PV bleeding // loss of contractions // hypotension + tachycardia // presenting part retracts back into vagina

33
Q

mx uterine rupture

A

C section

34
Q

what defines PPH

A

blood loss >500ml vaginally // >1L C section

35
Q

what is a primary vs secondary PPH

A

primary = within 24 hours // secondary = 24 hours - 6 weeks

36
Q

most common causes primary PPH

A

4 Ts: uterine aTony!!!! // trauma // tissue // thrombin (bleeding or clotting disorder)

37
Q

RF PPH

A

previous PPH // prolonged labour // pre-eclampsia // increased age // polyhydramnios // emergency c section // placenta problems // macrosomnia

38
Q

ABC mx PPH

A

lie women flat // group and save // crystalloid infusion

39
Q

ABC mx PPH

A

lie women flat // group and save // crystalloid infusion

40
Q

mechanical mx PPH

A

palpate fundus internally + catheterise patients

41
Q

medical mx PPH

A

IV oxytocin // IV or IM ergometrine // IM carboprost // sublinguinal misoprostol

42
Q

surgical mx PPH

A

intrauterine balloon tamponade

43
Q

what causes secondary PPH

A

retained POC or endometritis (infection)

44
Q

what is placenta accreta

A

placenta adheres too far into uterus –> myometrium

45
Q

symptoms placenta accreta

A

PPH

46
Q

diagnosis Placenta accreta

A

MRI

47
Q

RF Placenta accreta

A

previous C section, placenta praevia

48
Q

placenta accreta, increta, percreta

A

accreta: attach TO myometrium // increta: invade INTO myometrium // pecreta = THROUGH perimetrium

FINALS - OBS, GYNAE, BREAST (27 decks)

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